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Being a doctor abroad – comparing the Greek healthcare system with the NHS

Healthcare systems and training programmes vary significantly across the world. By learning about other healthcare systems, we can identify blind spots in our own system and continue to improve training. Sofia Anastasiadou, an ENT Registrar in South West England, describes...

Mastoid surgery for cholesteatoma

Landmark Paper: Toner JG, Smyth GDL. Surgical Treatment of Cholesteatoma: a comparison of three techniques. Am J Otol 1990;11(4):247-9. Canal wall up or canal wall down? Chris Aldren discusses the landmark paper that attempted to provide a definitive answer for...

Imaging in hyperparathyroidism

Following their caudal migration at eight weeks of development, the parathyroid glands normally locate posterolaterally to the upper pole of the thyroid gland at the level of the cricoid cartilage (superior parathyroid glands arising from the fourth branchial pouch and...

New ventilation technique FCV: improvement for patient, anaesthetist/intensivist and surgeon

Per-oral surgical access to the larynx can be hampered by the presence of an endotracheal tube. Various systems have been developed for tubeless ventilation, but these all carry a risk of aerosolisation of secretions with obvious inherent risks. We hear...

American Thyroid Association Thyroid Cancer Management Guidelines: utilising risk stratification to optimise patient care

The steep rise in thyroid surgery around the globe, has led to the development of risk stratification to define the indications for surgery and the extent of surgery as well as adjuvant therapies for papillary carcinoma, to avoid over treatment....

Cochlear implantation for single-sided deafness and asymmetric hearing loss

Continuing our sub-theme of cochlear implantation candidacy, Richard Irving and Raghu Kumar review the principles and benefits of cochlear implantation in individuals who have an asymmetric hearing loss. It is well known that cochlear implantation improves auditory capacity, and in...

The role of the maxillo-facial surgeon in the management of skull base malignancy

Whilst ablative surgery remains the principal treatment option for head and neck malignancy, the skull base is the last frontier. The complex anatomy, supreme functionality of the brain, and varied pathology provokes many a detailed discussion in the multidisciplinary team...

Middle ear reconstruction in children: why, when and how

Every ear in every child is different. Rob Nash discusses the rationale behind reconstructive ear surgery in children and his philosophy on timing and techniques of reconstruction. It is rare for middle ear pathologies to be life threatening. Indeed, it...

Non-surgical rhinoplasty

Some patients would like to alter the appearance of their nose without surgery or make further subtle changes after a rhinoplasty. Lydia Badia explains how this can be done, thanks to the advent of injectable fillers. This medical procedure in...

Getting It Right First Time in ENT

Andrew Marshall, a Consultant ENT Surgeon at Nottingham University Hospitals NHS Trust, visited 126 departments across England before publishing his recent ENT surgery national report for the Getting It Right First Time (GIRFT) programme. Here, he explains how identifying unwarranted...

Emerging robotic systems for head and neck surgery

As of December 2020, seven robotic surgical systems have received approval for use in different jurisdictions, and many more task-specific robots are in the pipeline. Jack Faulkner takes us through what’s on the horizon for head and neck cancer surgery....

Setting up a robotic surgical practice: view from India

Transoral robotic surgery has an established role in head and neck cancer surgery. But how easy is it to set up a service in a resource-constrained environment? Gouri Pantvaidya and Ameya Pai give us a view from the Indian subcontinent....